精神科护理：速成包

公式表、每个专题的关键方法步骤和 6 道练习题，完整解答附在最后。

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1公式与方法

精神科护理

方法

  1. 判断是否存在即时风险：自杀、暴力、药物急症或躯体疾病。
  2. 先保障安全：观察、移除危险物品、缓和局面、停用有害药物、寻求帮助。
  3. 选择治疗性回应：承认感受、陈述现实，避免虚假的安慰和“为什么”式提问。
  4. 尊重权利：采用限制最少的方案，知情同意，以及保密及其限度。

2练习题

1.精神科护理中等

Which criteria are needed for a diagnosis of intellectual disability?

  1. ALimits in both intellectual and adaptive functioning, starting in childhood
  2. BAn IQ score alone, measured at any time in adult life
  3. CMemory loss and confusion that start for the first time after the age of 65
  4. DProblems with reading only, with normal everyday functioning
2.精神科护理困难

During a panic attack, a patient breathes very fast and complains of light-headedness and tingling in her fingers and around her mouth. What should the nurse do?

  1. ALeave her alone so that she can calm down without anyone watching
  2. BAsk her to breathe into a paper bag for at least 10 minutes
  3. CStay with her and coach her to breathe slowly and steadily
  4. DGive her oxygen at a high flow rate through a mask
3.临床心理学中等

哪项特征可区分广泛性焦虑障碍和惊恐障碍？

  1. A对单一特定物体的恐惧，如蜘蛛或高处
  2. B对许多日常事务持续、过度的担忧
  3. C在数分钟内达到高峰的强烈恐惧突发
  4. D重复的仪式
4.临床心理学困难

情感表达研究表明，当家庭表现出什么时，精神分裂症更容易复发？

  1. A大量批评、敌意和情感过度卷入
  2. B温暖、平静的支持
  3. C经常谈论天气
  4. D接触很少
5.药理学中等

A malnourished patient with alcohol dependence needs IV glucose. Which vitamin should be given before or with it?

  1. AThiamine (vitamin B1)
  2. BVitamin D
  3. CVitamin C
  4. DVitamin K (phytomenadione)
6.药理学困难

A patient on weekly methotrexate is prescribed trimethoprim for a urinary infection. What is the main risk?

  1. AHypoglycaemia from reduced liver glucose output
  2. BLoss of antibiotic effect because methotrexate binds trimethoprim
  3. CSevere hypertension from the combination
  4. DBone marrow suppression, because both drugs inhibit folate metabolism

3溶液

1.精神科护理

答案: A · Limits in both intellectual and adaptive functioning, starting in childhood

为什么是这个答案

Intellectual disability requires limitations in intellectual functions and in adaptive functioning, such as communication, self-care and social skills, starting in childhood. Severity is based mainly on adaptive functioning.

答案

A · Limits in both intellectual and adaptive functioning, starting in childhood
2.精神科护理

答案: C · Stay with her and coach her to breathe slowly and steadily

为什么是这个答案

Hyperventilation causes respiratory alkalosis, which leads to tingling and dizziness. Calm coaching of slow breathing restores carbon dioxide levels. Breathing into a paper bag is not recommended, because it can cause hypoxia and mask a medical cause.

答案

C · Stay with her and coach her to breathe slowly and steadily
3.临床心理学

答案: B · 对许多日常事务持续、过度的担忧

为什么是这个答案

广泛性焦虑障碍是对多种事情持续、难以控制的担忧，至少持续六个月；惊恐障碍则是反复出现、出乎意料的惊恐发作。

答案

B · 对许多日常事务持续、过度的担忧
4.临床心理学

答案: A · 大量批评、敌意和情感过度卷入

为什么是这个答案

高情感表达预示着更高的复发率；降低情感表达的家庭干预可减少复发。

答案

A · 大量批评、敌意和情感过度卷入
5.药理学

答案: A · Thiamine (vitamin B1)

为什么是这个答案

Giving glucose without thiamine to a thiamine-deficient patient can trigger or worsen Wernicke's encephalopathy. Thiamine is therefore given before or alongside glucose.

答案

A · Thiamine (vitamin B1)
6.药理学

答案: D · Bone marrow suppression, because both drugs inhibit folate metabolism

为什么是这个答案

Trimethoprim and methotrexate both inhibit dihydrofolate reductase, and trimethoprim also reduces methotrexate excretion. The combination can cause severe pancytopenia, so another antibiotic is chosen.

答案

D · Bone marrow suppression, because both drugs inhibit folate metabolism

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